Abstract
Objective
One of the objectives of the Intersectoral Global Action Plan (IGAP) on epilepsy and other neurological disorders for 2022 to 2031 is to ensure at least 80% of people with epilepsy (PWE) will have access to appropriate, affordable, and safe anti-seizure medications (ASMs) by 2031. However, ASM affordability is a significant issue in low-and-middle-income countries, preventing PWE from accessing optimal treatment. This study aimed to determine the affordability of the newer (second and third-generation) ASMs in resource-limited countries in Asia.
Methods
We conducted a cross-sectional survey by contacting country representatives in Malaysia (upper-middle- in lower-middle-income countries (LMICs) in Asia, including Indonesia, Lao PDR, Myanmar, Philippines, Vietnam, India, Bangladesh, Pakistan, and Malaysia from March 2022 to April 2022. The affordability of each ASM was calculated by dividing the 30-day ASM cost by the daily wage of the lowest-paid unskilled labour. Treatment costing one day’s wage or less for a 30-day supply of chronic disease is considered affordable.
Results
Eight LMICs and one UMIC were included in this study. Lao PDR had no newer ASM, and Vietnam had only 3 newer ASMs. The most frequently available ASMs were levetiracetam, topiramate, and lamotrigine, and the least frequently available was lacosamide. The majority of the newer ASMs were unaffordable with the median number of days’ wages for a 30-day supply ranging from 5.6 to 14.8 days.
Significance
All new generation ASMs, either original or generic brands, were not affordable in most Asian LMICs.
MAY